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What Is Bone Cancer?

Primary bone cancer, also known as bone sarcoma, is a tumor that develops from the cells forming the bone. In general, sarcomas are tumors that start from the connective tissue, which is the tissue that connects, supports, and surrounds other body structures. This includes bone, muscle, fat, blood vessels, nerves, tendons, and the lining of the joints.

Bone cancer most commonly starts in the long bones of legs and arms, in the knee area and in the pelvis, but it can arise from any bone. The most common types of bone cancers are osteosarcoma, Ewing sarcoma, chondrosarcoma and chordoma. Osteosarcoma and Ewing sarcoma are especially frequent in children and teenagers, while chondrosarcoma and chordoma are mostly seen in adult patients. However, all bone sarcomas can occur at any age. Other types of sarcoma such as leiomyosarcoma, angiosarcoma, pleomorphic sarcoma, giant cell tumor of bone and other can also rarely arise in the bone. Some types of blood cancers start in the blood-forming cells of the bone marrow but not the bone itself. Those cancers are not discussed on this page and do not classify as bone cancer. 

Secondary bone cancer is a cancer that affects the bone but has originated from a different site than the bone. Many other cancers can spread (metastasize) to the bone, when that occurs, they are not classified as bone cancer but are named for where they began, such as lung cancer that has metastasized to the bone. Those cancers are not covered on this page.  

According to the American Cancer Society, there are approximately 3,900 new cases and 2,100 deaths from bone cancer each year.

Why Come to CU Cancer Center for Bone Cancer  

As the only National Cancer Institute Designated Comprehensive Cancer Center in Colorado and one of only four in the Rocky Mountain region, the University of Colorado Cancer Center has doctors who provide cutting-edge, patient-centered bone cancer care and researchers focused on diagnostic and treatment innovations.  

The CU Cancer Center has a multidisciplinary program for sarcomas, including bone cancer. This is a great option for patients who are recently diagnosed, looking for a second opinion, or already in treatment. Our team will gather a group of surgical oncologists, medical oncologists, radiation oncologists, pathologists, dietitians, genetic counselors, and more to make sure each patient is getting the best care that is unique to his/her diagnosis.

There are numerous clinical trials being conducted by CU Cancer Center members at any time, including trials that enroll bone sarcomas. These trials offer patients other options besides traditional bone cancer treatment. Your oncologist will be able to identify potential trials for which bone cancer is eligible.

Bone Cancer Prognosis and Survival Rates 

Bone cancer prognosis depends on the type of cancer and the stage at which it is diagnosed. Bone cancers account for less than 0.2% of all cancers in the United States. 

The five-year survival rate for bone cancer — the percentage of people who live at least five years after the disease is found —varies by the specific type of cancer. It ranges from 67% for osteosarcoma to 82% for chordoma.   

Our clinical partnership with UCHealth has produced survival rates higher than the state average for all stages of bone and joint cancers.

Acute Lymphocytic Leukemia Graph

Number of Patients Diagnosed – UCHealth – 48 – State of Colorado – 197
Number of Patients Surviving – UCHealth  – 33 – State of Colorado – 121
*n<30, 5 Year Survival – (Date of diagnosis 1/1/2010–12/31/2014)

Types of Bone Cancer

Bone cancers in children and teenagers include osteosarcoma and Ewing sarcoma. Common types of bone cancer in adults are chondrosarcoma, giant cell tumor, and chordoma.

Osteosarcoma is the most common type of bone cancer. It usually affects children and teenagers, but it can develop in any age group. Osteosarcoma typically starts in parts of the body where bones grow quickly — including leg bones, around the knee, arm bones, around the shoulder — but it can develop anywhere, including the pelvis, the skull, and jaw.

→ Disney+ Movie Raising Awareness of Osteosarcoma

Ewing sarcoma, also known as Ewing tumors, is most common in teenagers and older children. It most commonly develops in the chest wall (shoulder blades or ribs), pelvis, and long bones of the leg.

Chondrosarcoma is the second most common bone cancer in adults after the age of 40, although it can present at any age. Chondrosarcoma develops from cartilage cells that are found between bones and joints in the legs, arms or pelvis. It also can start in the shoulder blade, ribs, and skull, and even in the trachea, larynx, or chest wall.

Chordoma is most often found in adults 30 and older and is twice as common in men as in women. The tumors usually develop at the base of the skull and in the bones of the spine.

Giant cell tumors most frequently occur in young and middle-aged adults. They usually develop in the legs and arms.

Bone Cancer in Dogs 

More than 10,000 dogs are diagnosed with osteosarcoma each year. This cancer, while rarer in humans, is nearly identical and the treatment options are similar. More than 30 years ago, veterinarians at CU Cancer Center partner Flint Animal Cancer Center (FACC) at Colorado State University in Fort Collins helped develop a limb spare surgery technique for dogs that informed the same procedure in kids. Today, the FACC team continues to search for better therapies to treat primary bone cancer and tumor metastasis, which spreads to the lungs in approximately 80 percent of canine patients. A combination drug therapy developed at FACC for dogs with metastatic bone cancer is now in stage 2 clinical trials for humans at Children’s Hospital Colorado and Atlanta Children’s Hospital.

Risk Factors for Bone Cancer 

Bone cancer has multiple risk factors: behaviors or conditions that increase a person’s chances of getting a disease such as cancer. Risk factors for bone cancer include:

  • Genetic disorders including multiple exostoses syndrome, multiple osteochondromas syndrome, multiple enchondromatosis, tuberous sclerosis, and Paget disease.
  • Exposure to large doses of radiation.
  • Exposure to radioactive materials.
  • Bone marrow transplantation.

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Information reviewed by Breelyn Wilkey, MD, in August 2022.